Synchronous and Arguably Initially Resectable Hepatic Metastases

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CASE 26: A 49-year-old man presented with CT/PET evidence of primary cecal cancer with involved regional lymph nodes and small synchronous bilobar liver lesions. PET/CT identified scattered metastases, 6 in the right lobe and 1 in the left lobe, all measuring ≤2 centimeters. Radiologic margins relative to major vessels appeared adequate on assessment. (Presenter Dr. Axel Grothey, see other cases by Dr. Grothey)

CASE 27: A 64-year-old woman presented with a partially obstructing mass in her transverse colon found after a routine colonoscopy. Abdominal CT showed evidence of 3 peripherally located (2 centimeters or less) synchronous hepatic lesions in the right liver. (Presenter Dr. Axel Grothey, see other cases by Dr. Grothey)

CASE 28: A 50-year-old man was found to have a 70 percent circumferential rectal adenocarcinoma, 10 centimeters from the anal verge, with no evidence of lymph node involvement on transrectal ultrasound. CT showed a concurrent, solitary, unilobar, 3-cm left liver lesion with no other sites of visible metastasis. (Presenter Dr. Nicholas Petrelli, see other cases by Dr. Petrelli)

CASE 29: A 69-year-old Asian man is found to be mildly anemic upon routine checkup for chronic hepatitis B (HBV). Colonoscopy shows a tumor in the sigmoid colon and CT reveals a 1-cm indeterminate mass located in the dome of the liver, which is undetectable by ultrasound. Bilirubin is normal but AST level has doubled from baseline. Patient is otherwise very healthy. (Presenter Dr. Steven Alberts, see other cases by Dr. Alberts)

CASE 30: A 74-year-old female is diagnosed with a low rectal tumor and multiple synchronous small right liver metastases located within segments VI, VII and VIII. (Presenter Dr. John Primrose, see other cases by Dr. Primrose)

CASE 31: A 42-year-old woman with hematochezia and altered bowel movements is found to have a T3, node-positive rectal tumor 6 centimeters above the anal verge with 2 synchronous right hepatic lesions in segments V and VII, measuring 3 and 2 centimeters, respectively. PET confirms no evidence of extrahepatic disease. (Presenter Dr. Daniel Haller, see other cases by Dr. Haller)

CASE 32: A 72-year-old man was diagnosed with a T3N1 bleeding low rectal mass and 2 synchronous 3-cm hepatic metastases in segment VI of the right hemiliver. PET showed no evidence of extrahepatic disease. (Presenter Dr. Daniel Haller, see other cases by Dr. Haller)

CASE 33: A 62-year-old man who recently experienced myocardial infarction and coronary stent placement was found to have heme-positive stool and colonoscopic evidence of a rectosigmoid adenocarcinoma 6 centimeters from the anal verge. Staging CT revealed 2 small, peripheral liver metastases contained within the right lobe but no extrahepatic disease. (Presenter Dr. Steven Curley, see other cases by Dr. Curley)

CASE 34: A 38-year-old postpartum woman presents with rectal bleeding lasting a few months, previously attributed to hemorrhoids. She is diagnosed with primary sigmoid cancer with a synchronous, centrally located 5-cm liver metastasis in segment VII. (Presenter Dr. Alan Venook, see other cases by Dr. Venook)